The skin is the body’s largest organ. Its job is to protect internal organs against damage, heat and infection. The skin is also the most exposed organ to sunlight and other forms of harmful ultraviolet rays.

More than one million cases of basal and squamous cell skin cancers will be diagnosed in the United States this year. These cancers can usually be cured.

About 100,350 new melanomas will be diagnosed (about 60,190 in men and 40,160 in women). About 6,850 people are expected to die of melanoma (about 4,610 men and 2,240 women).

TYPES OF SKIN CANCER

Basal Cell Carcinoma – This is the most common form of skin cancer, and it is very curable. These cancers begin in the outer layer of skin (epidermis). Radiation therapy is very effective for treating basal cell cancers that have not spread elsewhere. Other common treatments include surgery, chemotherapy and cryosurgery.

Squamous Cell Carcinoma – This is the second most common type of skin cancer. These cancers also begin in the epidermis. Radiation therapy can be used to treat squamous cell cancers that start on the skin and sometimes nearby lymph nodes with or without surgery. Other common treatments include surgery, chemotherapy, cryosurgery and photodynamic therapy.

Melanoma – This is the most serious skin cancer. It begins in skin cells called melanocytes that produce skin color (melanin). Radiation therapy is used mostly for melanomas that started in another part of the body (metastases). It is used to treat areas where doctors think the disease may spread, such as the lymph nodes. Melanoma is usually treated first with surgery and may be followed by chemotherapy, radiation therapy and biologic therapy.

TREATING SKIN CANCER

The treatment you receive depends on several factors, including your overall health, the stage of the disease and whether the cancer has spread to other parts of your body. Treatments are often combined and can include the following:

• Radiation Therapy – The cancer cells are killed by ionizing radiation.
• Surgery – The cancer cells are cut out and removed.
• Moh’s Surgery – A microscopic surgery, Moh's surgery allows surgeons to remove tiny layers of cancerous tissue while preserving healthy tissue.
• Cryosurgery – The cancer is frozen and removed.
• Chemotherapy – The cancer cells are attacked by a drug that is either taken internally or applied on the skin.

EXTERNAL BEAM RADIATION THERAPY

External beam radiation therapy may be used to treat skin cancer itself or to relieve pain from cancer that has spread.

Radiation oncologists deliver external beam radiation therapy to the cancer from a machine outside your body. Doctors target the radiation beams at your tumor, giving more radiation to the skin cancer while keeping it away from underlying organs.

Skin cancer is often treated with superficial forms of radiation. That means the radiation penetrates only a short distance below the surface. Treatments are painless and take less than half an hour each, start to finish. Your treatment schedule will depend on your cancer, but it usually requires daily treatments for one or more weeks.

Radiation therapy can be given on its own or may also be given in addition to surgery, chemotherapy or biologic therapy.

UNDERSTANDING RADIATION THERAPY

Radiation therapy, also called radiotherapy, is the careful use of radiation to treat many different kinds of cancer.

• Cancer doctors, called radiation oncologists, use radiation therapy to try to cure cancer, to control cancer growth or to relieve symptoms such as pain.
• Radiation therapy works within cancer cells by damaging their ability to multiply. When these cells die, the body naturally eliminates them.
• Healthy cells that grow and divide quickly are also harmed by radiation, but they are able to repair themselves in a way that cancer cells cannot.
• Most radiation is given with an external beam, but treatment can be given with a radioactive source close to the skin with a treatment called brachytherapy, meaning “short-distance” treatment.

CARING FOR YOURSELF DURING TREATMENT

It is important to care for yourself as well as possible during radiation therapy.

• A balanced diet, a mild amount of physical activity, and taking time to rest are all important parts of your cancer treatment.
• Nutrition is important. Eat a balanced diet. Let your doctor know if you have trouble swallowing, food tastes funny or you have trouble eating.
• Follow your doctor’s orders, and if you are unsure of anything, ask your nurse or doctor any question you may have about your treatment.
• Be sure to tell your radiation oncologist about any vitamins or dietary supplements that you are currently taking to make sure they are safe to take during radiation therapy.
• Treat the skin exposed to radiation with special care. Stay out of the sun, avoid hot or cold packs, and only use lotions and ointments after checking with your doctor or nurse.
• You should also be sure to clean the skin over the areas receiving radiation therapy with warm water and mild soap.

Completing treatment and recovery can be challenging. Seek out help from support groups and friends ahead of time. If you have a support network in place before and during treatment, it will be easier to get through side effects, since people you can count on will be around to help you. If you need additional support, let your doctor and nurse know.

POTENTIAL SIDE EFFECTS

The side effects you might feel will depend on the part of your body being treated, the dose of radiation given and whether you also receive other treatments like chemotherapy. Before treatment begins, ask your doctor about possible side effects and how you can best manage them.

Nearly all patients will experience redness and moistness of the skin, similar to a brisk sunburn. After treatment ends, the skin will form a protective scab and the new, healthy skin will develop underneath it. This healing may take several months. You will also likely lose your hair in the area treated. Your hair may grow back, but it might not have the same texture or thickness.

Talk to your doctor or nurse about any discomfort you feel. He or she may be able to provide medications or other treatments to help.

© American Society for Radiation Oncology, 2016.